Can Heart Rate Variability analysis reduce analgesic requirements after laparoscopic cholecystectomy?

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This study investigates whether using a new pain monitoring device, the ANI monitor, can better predict how much pain-killing medication patients having keyhole gallbladder surgery need. During gallbladder removal patients are asleep and unaware but still need pain-killing medication such as morphine or fentanyl to make sure they are not in severe pain when you wake up. Anaesthetist currently estimate how much pain-killing medication is needed based on factors including patient age, body weight, thepatients response to the surgery judged by blood pressure/heart rate monitoring and the anaesthetists clinical experience. Using these methods, patients sometimes wake up after surgery with severe pain because the prediction of dose for pain-killing medicine during surgery was incorrect. In this study, we will be testing a new pain monitor which may be able to more accurately predict a patients analgesia requirements during surgery. This monitor requires two gel electrodes to be placed on your chest, alongside the gel electrodes that are put on by the anaesthetist for standard heart monitoring. It records heart rate with great accuracy and using complex mathematical formulas, generates a number (the acute nociception index) which may better predict the pain levels while the patient is anaesthetized. This study compares the comfort of patients waking up after gallbladder surgery when the monitor is used compared with standard care.